| Fusion Md Pllc | |
|
5472 Main St Suite 101 Del City OK 73115-5524 | |
| (405) 607-5920 | |
| Not Available |
| Full Name | Fusion Md Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5472 Main St, Del City, Oklahoma |
| Authorized Official Name and Position | Alicia Barton (OFFICE MANAGER) |
| Authorized Official Contact | 4056075920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fusion Md Pllc Po Box 19635 Oklahoma City OK 73144-0635 Ph: () - | Fusion Md Pllc 5472 Main St Suite 101 Del City OK 73115-5524 Ph: (405) 607-5920 |
| NPI Number | 1770936452 |
|---|---|
| Provider Enumeration Date | 07/19/2016 |
| Last Update Date | 07/19/2016 |
| Medicare PECOS PAC ID | 0042506701 |
|---|---|
| Medicare Enrollment ID | O20160906001343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770936452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ketti L Eddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194723239 PECOS PAC ID: 8426094475 Enrollment ID: I20050824000639 |
| Provider Name | Audralan Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689716219 PECOS PAC ID: 0143372235 Enrollment ID: I20090721000510 |
| Provider Name | Kristen E Bailey Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619473816 PECOS PAC ID: 4284981135 Enrollment ID: I20180724000060 |
| Provider Name | Maggie Joy Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215483920 PECOS PAC ID: 6305134602 Enrollment ID: I20180803002481 |
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